Provider Demographics
NPI:1598757692
Name:STEDIFOR-LEE, AMY CHERYL (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CHERYL
Last Name:STEDIFOR-LEE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:CHERYL
Other - Last Name:STEDIFOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:18207 RED EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3047
Mailing Address - Country:US
Mailing Address - Phone:281-460-1852
Mailing Address - Fax:
Practice Address - Street 1:9343 NORTH LOOP E
Practice Address - Street 2:STE 226
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1251
Practice Address - Country:US
Practice Address - Phone:713-674-5003
Practice Address - Fax:713-674-5009
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist